05/08/2015    Michael Brody, DPM

EHR Integrity Questions (Joseph Borreggine, DPM)

"How many times should patient EHR and billing
data be checked to ensure its integrity?"

This is a very interesting question and there
is no direct answer to this question. A loss of
data integrity can be difficult to detect,
the corruption of a single patient entry may
not cause the system to crash so you may look
at a patient chart and not even realize that
the data has been damaged in some manner.

My recommended solution is a very exhaustive
back up plan. The following backup plan assumes
your office is open Monday - Friday each week.

Daily Backup Devices labeled Monday, Tuesday
Wednesday and Thursday.

Every Monday you overwrite the Monday device
all the way through Thursday

Weekly Backup Devices labeled Week 1, Week 2..
through Week 5

The first Friday of the month you over the Week
1 disk, the second Friday the Week 2 disk, etc

Monthly Backup Devices labeled Jan, Feb....
Nov

Jan 31 you overwrite the Jan device and
continue on the last day of each month through
November

Dec 31 you make a backup up disk labeled 2015
(for this year) that disk is NEVER over-
written.

With this backup plan you can go back to any
point in time with your data and retrieve any
corrupted data by restoring the appropriate
disk.

"What issues could arise that could corrupt
data and hence their respective backup?"

Issues that can arise include:

Media Failure (the actual backup devices fails)

Backup Software failure (the backup routine did
not work properly)

Other hardware failure with the computer i.e.
USB port failure
User Error
Power Surges

"If the EHR and billing data cannot be restored
for some reason, then what is the next best
recourse?"

Pray? You need to do thorough backups and
actually test your backups by restoring a
backup on a regular basis. Loss of Data is a
HIPAA Violation and a violation of the civil
rights of your patients.

"What issues are there with respect to HIPAA
regarding possible irreparable data loss?"

There are quality of care issues, potential
medical legal issues, potential financial
issues (think audits with no records to
produce) and loss of patient data is a
violation of the patients civil rights.

Michael Brody, DPM, Commack, NY

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